PROJECT SUMMARY/ABSTRACT From the passage of the first US state sterilization law in Indiana in 1907 until the 1970s, approximately 60,000 people were sterilized based on eugenic criteria designed to limit the reproduction of the ?unfit?. Our team has produced original empirical historical analyses of this practice, using a dataset we created of over 20,000 sterilization approvals from California. Our interdisciplinary collaboration between historians and epidemiologists has generated methodological innovations and revealed important findings, including the disproportionate sterilization of Latina/o Californians, especially young Latinas, and the disparate implementation of consent processes across different demographic groups and different state hospitals. We propose to extend our analysis to North Carolina and Iowa, formalizing a method to rigorously integrate our quantitative epidemiologic approach with qualitative, historical analysis. To capture a more multiregional and layered understanding of eugenic sterilization in the United States in the 20th century, we propose to replicate and extend our analyses of the California eugenics records to include quantitative and qualitative data on 7,068 sterilization petitions from North Carolina between 1929 and 1974, and 2,185 sterilization applications from Iowa between 1934 and 1974. Ultimately our dataset will contain nearly 30,000 sterilization petitions, approximately one half of all eugenic sterilizations reported in the United States in the 20th century. We will produce, harmonize and analyze de-identified eugenic sterilization datasets for each state, including data on the gender, age, ethnicity, nationality, diagnosis, institutional home, and family history of patients considered for sterilization. We will analyze eugenic sterilization datasets in conjunction with individual-level Census microdata, estimating and comparing population-based sterilization rates. We will deepen the mixed methods approaches developed in our R21 analysis, integrating quantitative findings with in-depth qualitative analysis of notes on patient forms to generate a richer understanding of the experiences of 30,000 people sterilized during the eugenics era. This study is relevant to contemporary ethical, legal, and social issues in human genomics, as it will provide new scholarly knowledge about the ways in which a particular variant of genetic determinism resulted in the widespread state-mandated deprivation of reproductive capacity. We will examine how eugenic stereotypes about race and ethnicity, gender, sexual behavior, and intellectual disability influenced three states' interventions into the reproductive lives of institutionalized and vulnerable persons. Our findings can serve as a backdrop for contemporary conversations about the extent to which conceptions of normality, disability, and genetic stigmatization can insinuate themselves into the norms of disease prevention and human improvement.